Sticky ethical question

[deeman101]

My 2 cents: Unless there is beyond a shadow of a doubt that the person has no chance, then I don't endorse euthanasia. ie. Unless the person is brain dead. If there is a chance that these kids can do something with their lives, its not up to a doc or anyone to decide they should be denied that opportunity. These are not sheep or cattle (I won't go into animal rights), these are people. You could've quite easily been in that exact same situation. If I was one of those kids I'd murder the doc (if I could) for deciding that the best thing for me is to let me die. Sure maybe only 1 out of a 1000 could live a satisfying life. But you don't know which one that is, so I'd say the sensible thing to do is not deny any of them the opportunity.

[w8kg6]

Sure maybe only 1 out of a 1000 could live a satisfying life. But you don't know which one that is, so I'd say the sensible thing to do is not deny any of them the opportunity.

 

1 out of a hundred child mollesters and murderers might be innocent, so lets let all of them go free. It's a dumb argument, but it's the same as what you've made. Letting all of a undesirable strata of the population go by for the hopes that one will succeed.

 

The only difference is that with corrective care, people may be rehabilitated. With people who are institutionalized (at least with the severity that I'm talking about), it's just counting the days until the reaper comes. Which of the two is money well spent?

 

Also, I'm out for the night. Keep this going, I want to see where it's gone by tomorrow morning.

[future_doc]

Sorry, I couldn't resist.

 

lol, I only used the analogy once!

 

 

future_doc, I agree with everything you say, but the fact is that funds being put towards caring for these individuals with the sole purpose of prolonging their life until they die of old age mean funds are being taken away from other programs. I've already said that the resources (dollars, manhours, everything else) are significant, and are desperately needed elsewhere. Although allowing these people to die isn't ideal, we live in a less than ideal society. The resources would go a long way to protect society from the very thugs you've mentioned above, but as it stands, it's being spent prolonging the lives of the severely disabled until they can die 'naturally'.

 

I do realize you are stating the facts of life as they are. Doctors order pulling the plug on elderly patients with organ failure w/o even seeking family consent b/c they need the bed. This is called murder. Nobody cares, not even the family who are inheriting from the deceased. I know the reality but don't have to agree that it is right. I have never encountered such issues and hope never to. Funding decisions are made in committee and trickle down, so after all, nobody takes responsibility for these decisions based upon finance. Not that this is particularly relevant, when Red Cross makes an appeal b/c of some distaster and there is a tremendous financial response from the public is it a coincidence that offices then get refurbished and raises are given, etc.? Only as fraction goes to the distaster, the rest, less leakage, is supposedly used for future disasters. This is somewhat off topic except for financial resources being misallocated so that others may suffer.

[Prothrombin]

http://en.wikipedia.org/wiki/Godwin%27s_law

 

Sorry, I couldn't resist.

 

future_doc, I agree with everything you say, but the fact is that funds being put towards caring for these individuals with the sole purpose of prolonging their life until they die of old age mean funds are being taken away from other programs. I've already said that the resources (dollars, manhours, everything else) are significant, and are desperately needed elsewhere. Although allowing these people to die isn't ideal, we live in a less than ideal society. The resources would go a long way to protect society from the very thugs you've mentioned above, but as it stands, it's being spent prolonging the lives of the severely disabled until they can die 'naturally'.

 

Really, it's a social injustice to take so much away from society at large so that our most vulnerable can die of old age... but this is exactly what you're suggesting (and is exactly what occurs).

 

Do you realize how much "other" funding is being wasted besides that for prolonging the life of an individual?

[deeman101]

1 out of a hundred child mollesters and murderers might be innocent, so lets let all of them go free. It's a dumb argument, but it's the same as what you've made. Letting all of a undesirable strata of the population go by for the hopes that one will succeed.

 

If the stats are that high for wrong judgements being ruled then I'd argue its a problem with the judicial system. Whole 'nother thing.

[LostLamb]

future_doc, I agree with everything you say, but the fact is that funds being put towards caring for these individuals with the sole purpose of prolonging their life until they die of old age mean funds are being taken away from other programs. I've already said that the resources (dollars, manhours, everything else) are significant, and are desperately needed elsewhere. Although allowing these people to die isn't ideal, we live in a less than ideal society. The resources would go a long way to protect society from the very thugs you've mentioned above, but as it stands, it's being spent prolonging the lives of the severely disabled until they can die 'naturally'.

 

How do we know these people are living less than ideal lives for themselves? They only know what they are capable of comprehending and may be living very fulfilled lives. Just because they cannot express it does not justify 'us' deciding that they should not carry on, whether by taking away community-based care, or putting them in an institution, or *shudder* euthanasia.

 

Many of them are unable to tell us how they are feeling and what they are feeling. Just because they do not live the lives that WE lead does not mean theirs is not worthwhile. Judging the worth of one life to another is hard because we each only live our own.

 

Funds are squandered by governments in much worse places than by supporting daily needs, care, and so on of severely handicapped individuals. Just take a look at many bureaucrats and their 'expenses'...

In any case, while money is always needed 'elsewhere', the dollars and manhours going into the care of severely disabled individuals also provide employment to a significant number of individuals.

 

Maybe the 'outcomes' are not great in terms of "$$$ IN = what we perceive as a 'fulfilling' life". However, I think it is justified since we are at least treat them like people, working together with these individuals to give them the chance to live up to whatever their potential is.

[future_doc]

Yes, but if that person refuses medical treatment, then it is their right to be granted it.

 

Yes, but (somehow) that is not considered suicide, it is exercising one's right and freedom whether to accept medical treatment or not so long as the person is capable of giving informed consent.

[Halcyon]

Hey all. I was having a discussion with a friend earlier today, and he raised a few interesting points about a topic that will definitely be considered controversial (and hence appropriate for these forums). I work with a severely mentally handicapped youth, who is under 24/7 one on one care. The endgame in our program with the youth is a hope that he'll one day be able to spend an hour or so at home alone without beating the hell out of himself. He will never be able to have even a menial job, and is exceptionally low functioning. Our program costs the government about 280 000 dollars every year, even though it is being carried out in the youth's home. This is obviously very expensive, as the funds going to this one youth where very little can be expected in the way of results represent the salaries of 6 police officers or 2 family doctors. Given that there is very little that can be hoped for, and that it is unreasonable to expect the youth to ever be an even slightly productive member of society, my friend made the contention that euthanasia is warranted. He felt that even the 30 000 it would cost to institutionalize this youth would represent too heavy of an unnecessary cost on the Canadian economy, and that this differed from housing an inmate in that the inmate could be rehabilitated, while this is not a possibility for the youth I work with.

 

I'd like to hear your thoughts. I know that many will be against this idea, but please, support your feelings with sound ethical statements. Thanks for you time.

 

We are very fortunate to live in a nation that does fund these services and makes some effort to take care of all its citizens. That being said, there is much room for improvement (this is where voting comes in...).

 

I long for the day that we lose our self-centred outlook on all levels; that being, as individuals and in our families, communities, provinces, nationally, and globally. Sadly, money is often seen as more valuable than lives. And, of course, there's limited monetary resources to go around.

 

On a side note, the cost to provide care for that youth seems a bit high. Take the staff salaries (one staff x hourly rate of pay x 24/7 for a year), plus any administrative costs of the organization that provides the service (not too much b/c they'd be doing this for many youth). I'm going to guess it's roughly half of that amount? For the most part, care in one's home is cheaper than institutionalization (no facility costs for the service provider).

 

Regardless, a small price to pay for someone's life.

[The Law]

How is euthanasia even remotely an option here? That is the most inhumane, cruel and unusual action that could possibly be considered. In fact, it'd actually be murder in this case.

[future_doc]

How is euthanasia even remotely an option here? That is the most inhumane, cruel and unusual action that could possibly be considered. In fact, it'd actually be murder in this case.

 

agreed but it goes on more often than you would dream, by the medical profession

[Halcyon]

How is euthanasia even remotely an option here? That is the most inhumane, cruel and unusual action that could possibly be considered. In fact, it'd actually be murder in this case.

 

Pretty sad, eh? I couldn't even touch that one, haha. Glad you did!

[LostLamb]

We are very fortunate to live in a nation that does fund these services and makes some effort to take care of all its citizens. That being said, there is much room for improvement (this is where voting comes in...).

 

I long for the day that we lose our self-centred outlook on all levels; that being, as individuals and in our families, communities, provinces, nationally, and globally. Sadly, money is often seen as more valuable than lives. And, of course, there's limited monetary resources to go around.

 

On a side note, the cost to provide care for that youth seems a bit high. Take the staff salaries (one staff x hourly rate of pay x 24/7 for a year), plus any administrative costs of the organization that provides the service (not too much b/c they'd be doing this for many youth). I'm going to guess it's roughly half of that amount? For the most part, care in one's home is cheaper than institutionalization (no facility costs for the service provider).

 

Regardless, a small price to pay for someone's life.

 

Agree with you 100%.

 

The higher the needs, the greater the costs. I am going to hazard a guess that this individual described above may require more than one staff present at all times, might require specialized surroundings/protective wear, take expensive prescription medications, have specialized treatments or treatment regimes, and may have a larger support circle of specialists than others.

[deeman101]

Meds and premeds really love their ethical/moral debates . And very opinionated too evidently.

[AndrewB]

agreed but it goes on more often than you would dream, by the medical profession

 

I'm bothered by this statement. Do you know something that we don't?

[Michael777]

Yes, but if that person refuses medical treatment, then it is their right to be granted it.

 

This is considered passive Euthanasia, and it is legal in Canada.

 

"Passive euthanasia entails the withholding of common treatments (such as antibiotics, chemotherapy in cancer, or surgery) or the distribution of a medication (such as morphine) to relieve pain, knowing that it may also result in death (with informed consent). Passive euthanasia is the most accepted form, and it is a common practice in most hospitals"

 

Aside from this however, I am surprised no one has brought up the "slippery slope" argument. The "youth" in this situation is deemed to be unfit for society according to your friend, W8kg6. Who is your friend to make this judgement? Quality of life is not something that can be objectively measured and the minute we, as a society, start deciding who should die and who should live, we start heading down a very slippery path. Where do we draw the line? Should we kill the elderly who have many disabilities because we deem them to be of no value/a burden to society? I am sure I can come up with a hundred arguments...but long story short, if we are going to start "letting" people die without their consent (or when they don't have the capacity to make this decision) then we will start to run into the whole new problem of people taking advantage of the system and "letting" people die who didn't want to, but just couldn't voice their opinion because of disability.

[Cnussey]

I don't think the "outcome" or "results" should be the defining factor in the quality of care we give people. Each and every individual should be permitted a certain "quality" of life as their life permits it. Our economy may not be perfect, but I can think of a lot of other wasteful programs where our tax dollars are being flushed down the drain (EI benefits for people who decide to take a 6mth holiday from Alberta, perhaps).

 

Euthanasia is not ethical, by any means. I have watched time and time again families who "justify" themselves by saying "it's what they would want" when they remove the feeding tubes and IVs from dying loved ones. Rather than dying with a dose of morphine and a hydrated body from the cancer, these people die from starvation and dehydration before the cancer has the chance. Is that ethical? It's not an easy judgment to make, it would not be my choice (hence, my will)--but the choice of euthanasia for the good of the economy rather than the good of an intricate network of loving family and friends is unethical. We cannot determine who gets to live and who gets to have a better quality of live based on the results of treatment, or on the price.

 

Just imagine the implications! People send to their death-bed on false evidence, on a doctor's recommendation (which, as many of you know...is not perfect)...it is a difficult enough judgment to sign DNRs and CMO forms, might as well a form that says "he doesn't deserve the money".

[Cnussey]

How is euthanasia even remotely an option here? That is the most inhumane, cruel and unusual action that could possibly be considered. In fact, it'd actually be murder in this case.

 

Without my grandmother's consent (who was completely lucid) my aunts & uncles told the doctor to remove her feeding tube and iv--she starved to death in days rather than succumbing to cancer in a another few weeks.

 

My husband watched a family do the same to their mother who claimed "she would want it that way" and then they flew off to the Carribean for a wedding while she died, alone.

 

It's an option.

[Cnussey]

Yes, but (somehow) that is not considered suicide, it is exercising one's right and freedom whether to accept medical treatment or not so long as the person is capable of giving informed consent.

 

Depends on their mental status and the extent of medical care. For example, if I refused treatment for my sick children, they could be taken from me and treated by social services (rightfully so)...however, no one will force me to have them vaccinated.

[Cnussey]

http://en.wikipedia.org/wiki/Godwin%27s_law

 

Sorry, I couldn't resist.

 

future_doc, I agree with everything you say, but the fact is that funds being put towards caring for these individuals with the sole purpose of prolonging their life until they die of old age mean funds are being taken away from other programs. I've already said that the resources (dollars, manhours, everything else) are significant, and are desperately needed elsewhere. Although allowing these people to die isn't ideal, we live in a less than ideal society. The resources would go a long way to protect society from the very thugs you've mentioned above, but as it stands, it's being spent prolonging the lives of the severely disabled until they can die 'naturally'.

 

Really, it's a social injustice to take so much away from society at large so that our most vulnerable can die of old age... but this is exactly what you're suggesting (and is exactly what occurs).

 

No. I think it's an injustice that we believe that the money is supposed to go to people deemed "more valuable" because of their abilities and possible futures--some of these people will be crack-addicts, some more will be squandering money away from social services, some will rape young children, some will litter on the sidewalk--how are these people any more valuable? We cannot qualify one life as more valuable over another.

 

A compromise would be to place the youth in a good institution where the family can visit and the young man may be in comfortable and familiar surroundings; however, I do not think this decision should be made regarding the cost to society.

[NewfieMike]

I think the majority of people are getting the wrong idea about w8kg6's argument. The stance that "all human life is equal, we must treat them all the same" is a fair and just side to be on... if we lived in a world with limitless money and resources.

 

The way I took in w8's argument was to consider a hypothetical situation where the entire health care system is in a state of triage. We pay the fees to keep one person going and as a result 10 others suffer without treatment. If all human life is deemed equal, then putting all our eggs in one basket for the mentally disabled youth is doing more harm than good.

 

I doubt anyone here believes that it is the "right" thing to kill someone, but from a purely public health perspective, it makes sense in a limited-resource society to provide the maximum amount of gain with the minimum cost. It's just math.

[switcheroo]

I think the majority of people are getting the wrong idea about w8kg6's argument. The stance that "all human life is equal, we must treat them all the same" is a fair and just side to be on... if we lived in a world with limitless money and resources.

 

The way I took in w8's argument was to consider a hypothetical situation where the entire health care system is in a state of triage. We pay the fees to keep one person going and as a result 10 others suffer without treatment. If all human life is deemed equal, then putting all our eggs in one basket for the mentally disabled youth is doing more harm than good.

 

I doubt anyone here believes that it is the "right" thing to kill someone, but from a purely public health perspective, it makes sense in a limited-resource society to provide the maximum amount of gain with the minimum cost. It's just math.

 

Agreed. I admire the idealist stance that many of you have taken here, but the fact is that in a society with limited funds, this issue becomes one of distributive justice (anyone read Hebert?).

[Microbiodude]

No. I think it's an injustice that we believe that the money is supposed to go to people deemed "more valuable" because of their abilities and possible futures--some of these people will be crack-addicts, some more will be squandering money away from social services, some will rape young children, some will litter on the sidewalk--how are these people any more valuable? We cannot qualify one life as more valuable over another.

 

A compromise would be to place the youth in a good institution where the family can visit and the young man may be in comfortable and familiar surroundings; however, I do not think this decision should be made regarding the cost to society.

 

....some of them will become great national leaders, some of them will become professional atheletes, some of them may win a nobel prize, some might find a vaccine for HIV, some of them might find a cure to cancer.

 

We can never really know for sure how someone will turn up but they definitely have potential based on the abilities. For this individual in this discussion, we know based on their abilities they may not necessarily be the most productive member of society. Since we live in a world with limitations on resources we have to work on allocating it effectively. We can't give everyone what they want/ deserve. That $280K is coming from somewhere and the consequences are going to be affecting someone else. As was mentioned earlier on this thread if Canada funds a 1000 individuals who are suffering from this illness it would cost $280-million/ year. I've copied a link to give some perspective on what that kind of money can do/ go towards.

 

http://www.saskparty.com/assets/pdf/New%20Ideas/PuttingPatientsFirst.pdf

[Godot]

Well, I think it is reasonable. In 2007, there were 62307 docs in Canada (http://secure.cihi.ca/cihiweb/dispPa...a_25oct2007_e), and assuming a salary of 130K per doc, we could have had 4% more if we didn't institutionalize these people. 4% is significant by any measure, and I'm sure many 'productive' people would be alive today if the funds were allocated more efficiently (i.e. not spent on people with no hope of contributing).

 

Okay, but I question your assumption that spending more on health care (in an industrialized country with a good, established health care system) and doctors will absolutely save more lives. For example, Canada has fairly low doctor-patient ratios, yet our expected lifespan is in the top 5 in the world. In Japan, we see a similar case that many people live a long time without the country having a very high doctor-patient ratio. That's why I am not convinced that a mere 4% increase in doctors is going to make a significant, measurable outcome in the quality of life for everyone else. Maybe 8%. Who knows. It's not as straightforward as it seems.

 

This is getting a little off the initial topic, but ... The thing about money is $300 million is a lot for a health-care system but absolutely pennies when compared to is spent on other things. For example, $300 million would barely cover the payroll of 6 NHL teams, and probably only 2-3 MLB teams. (That's what, about ~22 NHL players, so 132 people sharing the wealth there.) I am just uncomfortable with the idea that as a society we're giddy at celebrities' excess (have you ever seen that show "The Fabulous Life of .."?) and indulge in wish-fulfilment fantasies about buying expensive cars, mansions, and then turn around and say that $300 million is too much for this or that. It's not. Hell, 10 celebrities could sell their summer homes in the Hamptons to make up the cost.

 

It's in this respect, dealing with health care and money, that I think Cuba has it right.

[Microbiodude]

Okay, but I question your assumption that spending more on health care (in an industrialized country with a good, established health care system) and doctors will absolutely save more lives. For example, Canada has fairly low doctor-patient ratios, yet our expected lifespan is in the top 5 in the world. In Japan, we see a similar case that many people live a long time without the country having a very high doctor-patient ratio. That's why I am not convinced that a mere 4% increase in doctors is going to make a significant, measurable outcome in the quality of life for everyone else. Maybe 8%. Who knows. It's not as straightforward as it seems.

 

This is getting a little off the initial topic, but ... The thing about money is $300 million is a lot for a health-care system but absolutely pennies when compared to is spent on other things. For example, $300 million would barely cover the payroll of 6 NHL teams, and probably only 2-3 MLB teams. (That's what, about ~22 NHL players, so 132 people sharing the wealth there.) I am just uncomfortable with the idea that as a society we're giddy at celebrities' excess (have you ever seen that show "The Fabulous Life of .."?) and indulge in wish-fulfilment fantasies about buying expensive cars, mansions, and then turn around and say that $300 million is too much for this or that. It's not. Hell, 10 celebrities could sell their summer homes in the Hamptons to make up the cost.

 

It's in this respect, dealing with health care and money, that I think Cuba has it right.

 

In that case perhaps we should set up a foundation and target it towards the rich. They can donate $300k per year and get a tax incentive for it as well.

[Microbiodude]

From another perspective, it would cost each Canadian roughly $10/ year to keep this program going.